|
E-mail this page to a friend!
Medicare Drug Program News
Seniors Being Hit Hard by Unexpected 16 Percent
Increase for Top Medicare Drug Plans
AARP MedicareRx Saver raised its average premiums
from $14.43 in 2007 to $26.56 in 2008, an 84% increase, according to
Avalere Health
 June
5, 2008 Gasoline prices, food prices everything is going up. Senior
citizens, however, are being quietly hit by a gigantic surprise in the
form of a premium increase in their Medicare prescription drug plan,
despite claims by the administration in January that prices were lower
for 2008. Instead, average monthly premiums for enrollees in the 10 most
popular Medicare prescription drug plans (PDPs) increased by 16% in
2008, according to new enrollment weighted analysis of Part D data
released today by Avalere Health.
| |
Related Stories |
|
| |
Medicare Says Projected Cost of Part D Drug Program
Continues to Drop
Survey finds 85% were aware of open enrollment
period, over 66% reviewed their current plan for cost and coverage
changes
Jan. 31, 2008
Senior Citizens Smarter About
Medicare Plans in
Closing Days of Open Enrollment
Largest marketer of Medicare drug programs says
their new tools help
Dec. 28, 2007
CMS Says New Regulations Will Better Protect Seniors
in Advantage and Drug Plans
Proposal tightens marketing rules, protects from
inappropriate cost sharing
May 8, 2008
Medicare Part D Has Helped More Seniors Take Their
Meds, But Sickest Most Likely to Skip
Many older Americans do not have a good understanding
of the complicated program
April 22, 2008
Medicare Advantage Plans to Get More Subsidy, Drug
Plans Get Higher Deductible
CMS to pay 3.6% more to MA plans, drug deductible
goes to $295 from $275 in 2009
April 9, 2008
Read the latest
news
>
Medicare
>
Medicare Drug Program
>
Senior Politics
>
Today's
Headline News |
|
The worst offender is the AARP MedicareRx Saver,
which raised its average premiums from $14.43 in 2007 to $26.56 in 2008,
an 84% increase.
A news release from the Centers for Medicare and
Medicaid Services in January said the projected cost of providing
Medicare beneficiaries with a prescription drug benefit through private
health plans has come down again.
The new enrollment data, released by the CMS in
late May, provides the most current detail on Medicare beneficiary plan
choices as of April 2008 and is the first comprehensive view of
beneficiary behavior post-open enrollment season.
While seniors faced a 16% average premium price
increase between June 2007 and April 2008, some of the most popular
plans including Humana PDP Standard, AARP MedicareRx Saver, and WellCare
Classic, raised their premiums by more than 50%.
"A 16% increase is significant in and of itself,
because premiums are rising rapidly at a time when Medicare
beneficiaries are finding it harder to afford it," Dan Mendelson,
president of Avalere,told the Los Angeles Times.
"These are individuals on a fixed income who are
facing rapidly rising prices elsewhere in the economy."
Indeed, he added, premiums for many seniors appear
to be going up faster than the cost of coverage for commercial insurance
plans that serve workers and their families, according to the Times
report by Ricardo Alonso-Zaldivar.
"Data from Mercer, a benefits consulting firm, show
that drug-benefit costs rose a little more than 9% last year for large
employers. Both kinds of coverage are delivered by private insurers, but
because the Medicare plan is heavily subsidized by taxpayers, a precise
comparison is difficult," wrote Zaldivar.
"Although seniors are one of the most important
groups of voters, Medicare has not been a major issue so far in this
year's election," he added. "But the rise in prescription premiums may
boost Democratic proposals to authorize Medicare to negotiate prices
with the pharmaceutical industry."
(Click
here for the complete Los Angeles Times report.)
The analysis also found that the average premium
increase was lower than if Medicare beneficiaries had stayed in the same
top 10 plans as last year. If beneficiaries in the top 10 plans for 2007
had stayed in their plans, premiums would have increased by about 21%.
| |
25.4 million
in Part D |
| |
Overall, about 90 percent of the nations
44 million Medicare beneficiaries have drug coverage from
Medicare or another source.
Approximately 25.4 million are enrolled
in Part D; 6.6 million retirees are enrolled in employer or
union-sponsored retiree drug coverage that receives the Retiree
Drug Subsidy (RDS); and 7.5 million are receiving drug coverage
from other alternative creditable sources such as TRICARE; the
Federal Employees Health Benefits Program; the Department of
Veterans Affairs or from their current employers.
Click here to National and State enrollment data |
"Medicare beneficiaries are conscious of value, and
many switched into lower cost plans for 2008," said Penny Mills, vice
president at Avalere.
For example, SilverScript's enrollment increased
38% after reducing its premium from $27.40 in 2007 to $20.84 in 2008, a
30% difference. At the same time, SilverScript significantly increased
the number of drugs covered on its formulary, while other plans were in
the process of reducing the generosity of their drug coverage (e.g.,
increasing cost sharing).
Other key findings from Avalere's analysis:
● The top 10 Part D organizations are no longer
consolidating enrollment. Their share of the market shrank from 75% in
June 2007 to 72% in April 2008. This reflects the fact that United and
Humana lost a large share of individuals dually eligible for Medicare
and Medicaid, as well as the commercial success of a number of
competitive smaller plans including regional Blue Cross plans that carry
strong name recognition.
● Enrollment in Medicare preferred provider
organizations (PPOs) - which many analysts declared dead - grew
substantially. The lifting of the two-year moratorium imposed by the
Medicare Modernization Act on new local PPO contracts was lifted at the
end of December 2007 and the market responded. Enrollment in local PPOs
grew 64% and enrollment in regional PPOs grew 80%. The winners in these
products were large health plans including United, Humana, and
WellPoint.
● Enrollment in private fee-for-service (PFFS)
plans continued to grow, albeit less rapidly than last year. The number
of beneficiaries receiving drug coverage through PFFS plans grew by 30%,
reflecting the success of voluntary marketing restrictions adopted by
the major plans as well as the probable saturation of the individual
markets in profitable areas.
View Avalere's analysis of the most current
enrollment data and premium prices for the 10 most popular Medicare drug
plans below.
Enrollment-Weighted Average
Premiums for the Top 10 PDPs By Enrollment as of April 2008
|
PDP Offering
(Parent Organization) |
April 2008 Plan
Enrollment |
2007 Average
Premium* |
2008 Average
Premium* |
% Change
(2007-2008) |
|
AARP MedicareRx Preferred
(UnitedHealth Group) |
2,755,548 |
$27.93 |
$32.08 |
15% |
|
Humana PDP Standard (Humana) |
1,559,432 |
$15.14 |
$25.53 |
69% |
|
Humana PDP Enhanced (Humana) |
1,396,474 |
$22.02 |
$23.35 |
6% |
|
Community CCRx Basic
(Universal American) |
1,109,224 |
$28.92 |
$24.97 |
-14% |
|
AARP
MedicareRx Saver (UnitedHealth Group) |
829,999 |
$14.43 |
$26.56 |
84% |
|
WellCare Classic (WellCare) |
597,711 |
$15.80 |
$24.68 |
56% |
|
MedicareRx Rewards Value
(WellPoint) |
485,247 |
$24.59 |
$25.39 |
3% |
|
SilverScript (CVS Caremark) |
482,719 |
$27.40 |
$20.69 |
-30% |
|
Prescription Pathway Bronze
(Universal American) |
457,832 |
$25.24 |
$23.58 |
-7% |
|
Health Net Orange Option 1
(Health Net) |
433,702 |
$22.24 |
$19.29 |
-13% |
|
Top 3 PDPs (by 2008
enrollment) |
|
$22.57 |
$28.15 |
25% |
|
Top 10 PDPs (by 2008
enrollment) |
|
$22.80 |
$26.39 |
16% |
|
All PDPs |
|
$27.39 |
$30.02 |
10% |
Source: Avalere Health analysis using
2008 landscape files for PDPs released September 27, 2007 by the
Centers for Medicare and Medicaid Services (CMS). 2007 data from
November 2006.
* 2007 offerings
enrollment-weighted with July 2007 enrollment data. 2008 offerings
enrollment-weighted with May 2008 enrollment data.
Avalere Health is a leading advisory company
focused on business strategy and public policy. It serves a diverse
client base, which includes Fortune 500 healthcare technology companies,
federal government agencies, and major medical foundations. The company
is organized into seven substantive areas - Medicare, Medicaid,
Reimbursement, Long-Term and Post-Acute Care, Health Information
Exchange, Evidence-Based Medicine, and Education. Anchored by a
comprehensive research engine and staffed by experts in business,
medical product commercialization, and health policy, Avalere provides
strategic guidance, objective analytic research, and quality educational
programs focused on the full range of healthcare issues facing our
nation.
Further information can be obtained at
www.avalerehealth.net.
|
Nursing Home Abuse, Medical Malpractice? Contact a lawyer.
click here
|
|
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
